The nurse has assessed 4 children. Which finding requires immediate follow-up with the health care provider?

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11ecbb05_caf3_36b3_b433_2b05f5757cb1_MD0009_00 Hypospadias is a congenital defect in which the urethral opening is on the underside of the penis. Except in very mild cases, the condition is typically corrected around age 6-12 months by surgically redirecting the urethra to the penis tip. Circumcision is delayed so the foreskin can be used to reconstruct the urethra. If not corrected, clients may have toilet-training difficulties, more frequent urinary tract infections, and inability to achieve erections later in life. Postoperatively, the client will have a catheter or stent to maintain patency while the new meatus heals. Urinary output is an important indication of urethral patency. Fluids are encouraged, and the hourly output is documented. Absence of urinary output for over an hour indicates that a kink or obstruction may have occurred and requires immediate follow-up (Option A). (Option B) Absence seizures are brief moments of staring accompanied by a lapse in awareness. These seizures often go undetected and do not cause physical injury. (Option C) Small amounts of blood-tinged sputum are normal after bronchoscopy; however, frank bleeding or clots should be reported. (Option D) Electrolyte disturbances commonly occur with gastroenteritis due to prolonged or heavy vomiting and diarrhea. This client's sodium and temperature are slightly abnormal but not critical. Educational objective: Hypospadias, a condition in which the urethral opening is on the underside of the penis, is surgically corrected by rerouting the urethra and inserting a temporary stent to aid healing. Urinary output is closely monitored postoperatively to ensure patency.

The Nurse Has Assessed 4 Children